Retreatment Instruments Research Articles

The efficacy of ProTaper Universal rotary retreatment instrumentation to remove single gutta‐percha cones cemented with several endodontic sealers

To evaluate residual root filling material following removal of three newly developed root canal sealers used with a matched-taper single-cone root filling technique and to compare the efficacy of ProTaper Universal rotary retreatment instruments with that of a conventional manual technique. The canals of 120 palatal roots in maxillary molar teeth were instrumented with EndoWave nickel-titanium rotary instruments and filled using Hybrid Root SEAL, EndoSequence BC Sealer, Activ GP system or AH Plus with matched-taper single gutta-percha cones. The root fillings were then removed with ProTaper Universal retreatment rotary instruments or a manual technique. Buccolingual and proximal digital radiographs of the roots were exposed to determine the area of remaining filling material in the coronal, middle and apical thirds. The area percentages of remaining filling material in each third and total canal area were calculated. Data were analysed statistically with Kruskal-Wallis and Mann-Whitney U-tests. The level of significance was set at P<0.05. Irrespective of the sealer type and retreatment technique, filling material could not be removed completely from the root canals. Significantly, more remaining filling material was observed in the apical third (P<0.05). When comparing the sealers, the only significant difference was detected between AH Plus/manual and Activ GP/manual groups with respect to residual material in the total canal area (P<0.05). There were no significant differences between manual and ProTaper groups. When using gross radiographic criteria, the Activ GP was more effectively removed from root canals than AH Plus with hand instrumentation. Hybrid Root SEAL, EndoSequence BC Sealer and AH Plus were removed to a similar extent. ProTaper Universal retreatment instruments were as safe and effective as hand instruments in reaching the working length.

Efficacy of D‐RaCe and ProTaper Universal Retreatment NiTi instruments and hand files in removing gutta‐percha from curved root canals – a micro‐computed tomography study

To compare the efficacy of two rotary NiTi retreatment systems and Hedström files in removing filling material from curved root canals. Curved root canals of 57 extracted teeth were prepared using FlexMaster instruments and filled with gutta-percha and AH Plus. After determination of root canal curvatures and radii in two directions, the teeth were assigned to three identical groups (n = 19). The root fillings were removed with D-RaCe instruments, ProTaper Universal Retreatment instruments or Hedström files. Pre- and postoperative micro-CT imaging was used to assess the percentage of residual filling material as well as the amount of dentine removal. Working time and procedural errors were recorded. Data were analysed using analysis of covariance and analysis of variance procedures. D-RaCe instruments were significantly more effective than ProTaper Universal Retreatment instruments and Hedström files (P < 0.05). Hedström files removed significantly less dentine than the rotary NiTi systems (P < 0.0001). D-RaCe instruments were significantly faster compared to both other groups (P < 0.05). No procedural errors such as instrument fracture, blockage, ledging or perforation were detected in the Hedström group. In the ProTaper group, four instrument fractures and one lateral perforation were observed. Five instrument fractures were recorded for D-RaCe. D-RaCe instruments were associated with significantly less residual filling material than ProTaper Universal Retreatment instruments and hand files. Hedström files removed significantly less dentine than both rotary NiTi systems. Retreatment with rotary NiTi systems resulted in a high incidence of procedural errors.

A comparative evaluation of efficacy of protaper universal rotary retreatment system for gutta-percha removal with or without a solvent

Aim:The aim was to evaluate and compare the efficacy of ProTaper Universal rotary retreatment system with or without solvent and stainless steel hand files for endodontic filling removal from root canals and also to compare retreatment time for each system.Materials and Methods:Thirty extracted mandibular premolars with single straight canals were endodontically treated. Teeth were divided into three major groups, having 10 specimens each. Removal of obturating material in group 1 by stainless steel hand files with RC Solve, group 2 by ProTaper Universal retreatment instruments and group 3 by ProTaper Universal retreatment instruments along with RC solve was done. Retreatment was considered complete for all groups when no filling material was observed on the instruments. The retreatment time was recorded for each tooth. All specimens were grooved longitudinally in a buccolingual direction. The split halves were examined under a stereomicroscope and images were captured and analyzed. The remaining filling debris area ratios were considered for statistical analysis.Results:With ANOVA test, statistical analysis showed that there was statistically no significant difference regarding the amount of filling remnants between the groups (P < 0.05). Differences between the means of groups are statistically significant regarding the retreatment time.Conclusion:Irrespective of the technique used, all the specimens had some remnants on the root canal wall. ProTaper Universal retreatment system files alone proved to be faster than the other experimental groups.

Torsional Resistance of Retreatment Instruments

Introduction This study compared the torsional resistance of two brands of rotary nickel-titanium (NiTi) instruments indicated for endodontic retreatment. Methods Mtwo retreatment instruments #15 and #25 (VDW, Munich, Germany) and ProTaper Universal retreatment instruments D2 and D3 (Maillefer/Dentsply, Ballaigues, Switzerland) were subjected to a torsional assay in clockwise rotation. The two parameters evaluated were maximum torque and angular deflection at failure. Fractured instruments had their fractured surfaces and helical shafts examined by scanning electron microscopy. Results The results indicated that the angular deflection at fracture decreased in the following order: Mtwo retreatment file #15 > Mtwo retreatment file #25 > ProTaper Universal retreatment file D2 > ProTaper Universal retreatment file D3. As for the maximum torque values, the results revealed the following descending order: ProTaper Universal file D2 > Mtwo retreatment file #25 > ProTaper Universal file D3 > Mtwo retreatment file #15. Scanning electron microscopic analysis revealed that plastic deformation occurred along the helical shaft of the fractured instruments. Fractured surfaces were of the ductile type. Conclusions The instruments tested showed different torsional behavior depending on the parameter evaluated. If one considers that high angular deflection values may serve as a safety factor, then the Mtwo retreatment instruments showed significantly better results.

Flexibility and torsional resistance of three nickel-titanium retreatment instrument systems

To assess the dimensional characteristics, flexibility and torsional behaviour of nickel-titanium retreatment instruments. Using image analysis software and high-resolution digital images, the instrument length, tip angle, diameter at 3 mm from the tip and the distance between the blades (pitch length) of the following eight instruments were measured (n = 12 for each measurement parameter): the ProTaper Universal retreatment (PTU-R) D1, D2 and D3 instruments; the R-Endo R1, R2 and R3 retreatment instruments; and the Mtwo retreatment (Mtwo-R) sizes 25 and 15 retreatment instruments. Maximum torque and the angular deflection at fracture as well as the bending moment at 45° were measured (n = 12) according to the International Standards Organisation (ISO) specification number 3630-1. Data were analysed using the analysis of variance (α = 0.05). The length of the active part of the instruments was found to vary according to the depth of the canal into which they were designed to reach. The pitch length also increased along the active length. The PTU-R D1 and the Mtwo-R instruments had active tips. Measurements of the bending moment at 45° revealed that the Mtwo-R 15 instrument was the most flexible, whereas the PTU-R D1 was the least flexible. The maximum torque tended to increase as the instrument diameter at 3 mm from the tip increased, whereas the angular deflection at fracture varied in the opposite direction. The geometrical characteristics of the retreatment instruments and their flexibility and torsion behaviour were consistent with their intended clinical application.

A comparison of the efficacy of conventional and new retreatment instruments to remove gutta‐percha in curved root canals: an ex vivo study

To compare the efficacy of conventional and new retreatment instruments when removing gutta-percha root fillings in curved root canals. A total of 56 curved molar roots were instrumented with ProFile instruments and filled using system B and Obtura II. The root fillings were removed with manual K-files and Hedström files (Dentsply Maillefer), ProFile (Dentsply Maillefer), R-Endo (Micro-Mega) or ProTaper Universal retreatment files (Dentsply Maillefer). Eucalyptol was used as a solvent with all techniques. Bucco-lingual and proximal radiographs of the roots were exposed and the percentage area of the remaining material was calculated by dividing the area of remaining filling material by the area of canal wall. Data were statistically analysed with Kruskal-Wallis and Mann-Whitney U tests (P = 0.05). None of the techniques completely removed the root filling materials. No significant differences were found amongst the coronal, middle and apical thirds in both radiographic projections (P > 0.05). In the bucco-lingual direction, the remaining filling material was significantly less following manual instrumentation than R-Endo and ProTaper instrumentation (P < 0.05). In the proximal view, it was significantly less following manual and ProFile instrumentation than R-Endo (P < 0.05). Complete removal of filling material occurred only in three specimens (with manual instruments). Manual instruments were significantly faster than R-Endo and ProFile (P < 0.05). More procedural errors (five fractured instruments and two perforation) were noted when using ProTaper (P < 0.05). In this laboratory study in curved molar roots, ProTaper Retreatment and R-Endo instruments were less effective in removing filling material from canal walls than manual and ProFile instruments.